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논문 기본 정보

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학술저널
저자정보
Kyung-Hwak Yoon (Department of Surgery Seoul National University Bundang Hospital Seoul National University College) Sumin Chae (Department of Surgery Kyung Hee University Medical Center Kyung Hee University School of Medicine) Eunyoung Kang (Department of Surgery Seoul National University Bundang Hospital Seoul National University College) Hee-Chul Shin (Department of Surgery Seoul National University Bundang Hospital Seoul National University College) Jee Hyun Kim (Department of Internal Medicine Seoul National University Bundang Hospital Seoul National Universi) In Ah Kim (Department of Radiation Oncology Seoul National University Bundang Hospital) So Yeon Park (Department of Pathology Seoul National University Bundang Hospital) Sung-Won Kim (Department of Surgery Daerim St. Mary's Hospital) Eun-Kyu Kim (Department of Surgery Seoul National University Bundang Hospital Seoul National University College)
저널정보
한국유방암학회 Journal of Breast Cancer Journal of Breast Cancer Vol.22 No.4
발행연도
2019.1
수록면
587 - 598 (12page)

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Purpose: We evaluated the risk of contralateral breast cancer (CBC) and ipsilateral breast tumor recurrence (IBTR) and investigated the predictive factors for CBC and IBTR in breast cancer patients with BRCA mutations and non-carriers at high-risk of hereditary breast and ovarian cancer (HBOC). Methods: We analyzed prospectively collected clinical data of patients with unilateral breast cancer who were at high-risk for HBOC and were tested for the BRCA mutation between 2003 and 2013. Results: The cohort comprised 540 patients with 45 BRCA1 carriers, 50 BRCA2 carriers, and 445 non-carriers. The median follow-up was 84.5 months. Overall, 61 patients (11.3%) developed CBC (24.4% for BRCA1 carriers, 20% for BRCA2 carriers, and 9% for non-carriers). The 10-year cumulative risk for CBC was 23.8% for BRCA1 carriers, 19.1% for BRCA2 carriers, and 9.8% for non-carriers (p = 0.174). Among the 277 patients who underwent breast-conserving surgery, 29 (10.5%) developed IBTR (9.1% for BRCA1 carriers, 16.7% for BRCA2 carriers, and 10.2% for non-carriers). The 10-year cumulative risk for IBTR for BRCA1 carriers, BRCA2 carriers, and non-carriers was 8.7%, 14.1%, and 20%, respectively (p = 0.577). BRCA1 (hazard ratio [HR], 2.94; 95% confidence interval [CI], 1.20–7.20; p = 0.019) and BRCA2 (HR, 2.88; 95% CI, 1.13–7.35; p = 0.027) mutations and negative estrogen receptor status (HR, 4.02; 95% CI, 1.60–10.08; p = 0.003) were the significant predictive factors for CBC, while tumor size ≥ 2 cm was predictive of IBTR (HR, 6.11; 95% CI, 2.03–18.33; p = 0.001). Conclusion: While BRCA1/2 mutation carriers had a higher risk of developing CBC compared to non-carriers at high-risk of HBOC, the risk of IBTR was similarly high across breast cancer patients irrespective of the BRCA mutation. Further preventive strategies to reduce CBC and IBTR for all patients at high-risk of HBOC should be investigated.
#Breast neoplasms #Genes #BRCA1 #Genes #BRCA2 #Hereditary breast and ovarian cancer syndrome #Risk factors

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참고문헌 (30)

참고문헌 신청
Claus EB / 1996 / The genetic attributable risk of breast and ovarian cancer / Cancer 77:2318~2324 google schola Robson ME / 2001 / Hereditary breast cancer / Curr Probl Surg 38:387~480 google schola Antoniou A / 2003 / Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history : a combined analysis of 22 studies / Am J Hum Genet 72:1117~1130 google schola Chen S / 2007 / Meta-analysis of BRCA1 and BRCA2 penetrance / J Clin Oncol 25:1329~1333 google schola 한상아 / 2009 / BRCA1 및BRCA2 유전자 돌연변이에 기인한 한국인 유방암 및 난소암 위험도: 예비 연구 결과보고 / Journal of Breast Cancer 12(2):92~99 dbpia

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